Future Clinical Trial of Adjuvant Chemotherapy with Sensitivity Test
There is no doubt that gastrectomy with extended lymph node resection is the curative treatment of choice for gastric cancer. Because some patients undergoing curative resection for gastric cancer relapse, adjuvant cancer chemotherapy has been actively studied. Although many drugs have shown activity against recurrent and advanced gastric cancer, the efficacy of single-agent chemotherapy was limited without increased survival benefit . The response rates after a single agent were reported to be less than 20%, as shown in Table 1, except mitomycin C (MMC), which was tested as single-agent therapy before the present response criteria were introduced. Cisplatin (DDP) was tested against the present criteria of response, and 5-fluorouracil (5-FU) was tested in many patients with gastric cancer; their response rates (21% and 19%, respectively) are considered to be the standard of efficacy for single agents on gastric cancer. Because of the low efficacy of single agents, several combination regimens have been developed: 5-FU + adriamycin (ADM) + MMC (FAM); etoposide + ADM + DDP (EAP); 5-FU + leucovorin (LV) + epirubicin (EPI) (FLEP); and 5-FU + DDP (FP).
KeywordsGastric Cancer Adjuvant Chemotherapy Gastric Cancer Patient Advanced Gastric Cancer Resistant Group
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